A move to cultrually mature the population was taken up by a series of publishers who attempted to provide literature, religious and general information items in the vernaccular intended mainly for popular readership. This move was initiated in the late nineteenth century by Alfons Marija Galea who during the period 1899 to 1915 published a series of 150 books in the Maltese language Cotba tal Moghdija taz-Zmien dealing with various aspects literature and instruction. Galea (b.1861 d.1941), a member of the most notable bourgeois families in the nineteenth century, rose to prominence mainly through his philanthropic activities. Before Galea's publishing enterprise, authors had to publish their own books when they had the means so that publications were few and far between2.

The Government Press also contributed towards popular medical education, through publications issued from the Department of Health. These included a number of pamphlets or books in the vernacular addressing various aspects of public health including Twissiiet fuk il Mard tal Kollra mehrugin mill Gvern biex jixxerdu fost in-nies (1885); Fuq il mard tat-tfal u kif nilqulu (1885); Chielmtejn fuk il-Pesta u chif yekrida by G. Caruana Scicluna (1901); Id-dubbien u n-nemus u chif nilkghu ruhna mill-hsarat taghhom by A. Critien (1929); and Il-Grieden (1936); and published lecture notes aimed at paramedical personnel including Ktieb il Qabla by S.L. Pisani (1883); Taghlim ghal l-istudenti ta' l-Iscola tal-Kwiebel ta' l-Isptar Centrali by G.B. Schembri (1897); and Il Ctieb ta l'Infermier by J.S. Galizia (1904)3.

Alfons Maria Galea's initiative injected new blood into Maltese publishing, while it made books more easily accesible to popular demand. An analysis of the collection shows titles dealing with travel, geography, history, archaeology, natural history, folklore, and technical education. Fiction apperars to have been less popular with 7 novels, 12 plays, 4 works of poetry, and 18 works dealing with religious themes. Four issues dealt with medical subjects. Issue No.22 Nibzghou ghal sahhitna. Taghlim ghat-Tfal was a self care booklet aimed at children written by A. Preca (1902). Issue No.54 of the series included two sections -Taghlim ghall-Ommijiet fuq it-Trobbbija ta' Uliedhom by E.B. Vella (1906) published for the "Pro Infantia" association and Ghajnuna fil mard ghal Gharrieda - Fuk l'Epidemji by F. Borg. The latter had been previously published in booklet form with the same title (1880) and in the popular newspapers Habbar Malti (1880) and Is-Salib (1902)4.

Cotba tal Moghdija taz-Zmien also republished other medical educational publications by F. Borg. Issue No. 61 Is-Sahha u 'd-dar (1907) which dealt with home and enviornmental hygene, had been previously published in Habbar Malti in 1879, while Issue No. 110 of the series Is-Sahha tal ulied had first appeared in Is-Sebh in 1884 and published in booklet form in 1884 as Kelmtejn fuq is-sahha tal ulied . This dealt with child care It also included a section Mard l Ghajnejn f'it-Trabi written by L. Manche, and Fuk il Mard ta' n-Nies ta' s-Snajja by G. Busuttil. The latter, written originally in 1885, dealt with industrial disease and injuries of various trades 5.

A significant proportion of the vernacular literature dealt with infant care. The high infant mortality had long preoccupied the medical profession and a number of efforts dating to the late nineteenth century were made to attempt reduce this by attempting to educate the population in aspects of child care. The infant mortality at the time was excessively high averaging 250 per 1000 live births. The rate came down only after the Second World War. The "Pro Infantia" association was founded some time before 1905 with the object of spreading practical hygienic measures to reduce the infant death rate. It published in 1907 an informative booklet about child care It-Trobbija Tat-Tfal jeu Tuissijet ghall ommijiet written by Dr. L. Manche and translated into maltese by Avv. E.L. Vella. The booklet dealt with marital/pregnancy problems, and infant/child care6.

Alfons Maria Galea further contributed to medical practice in Malta by being the "tour de force" as administrator in the massive work undertaken by Emilia Zammit Clapp and her sister Mary Zammit in the construction of a hospital in memory of Emilia's husband Henry Lyman Clapp, with whom he cooperated to ensure the projects being brought to fruition. The Zammit sisters on the 23rd June 1911 donated the new hospital - Zammit Clapp Hospital - to the Government in commemoration of the coronation of King George V and Queen Mary. This on the 29th August 1911 was utilized as a Seaman's Hospital under the charge of the Sisters of the Little Company of Mary (Blue Sisters). Medical care and instruments were provided by the Government, while nursing and general care of the patients was provided by the Sisters against payment by the Board of Trade or other parties7.

The St. John's Ambulance Brigade in Malta published a book in Maltese dealing with first aid, this being a translation of the work by J. Cautlie - L'Ewwel Ghajnuna lil mim ikorri . The first edition was published in 1916 and was based on the translation by R.J. Sammut. The second edition in 1934 was translated by T. Zammit, while the third and fourth editions (1938-1943) were translated by R.L. Casolani. An undated first aid book for use during wartime L-ewwel ghajnuna lil mim ikori fi zmien ta' gwerra was published by G. Galea8 .

This cultural propogation of the maltese language was taken up by Dr. Guze Bonnici in 1938 as editor of Gabra ta' Kitba Maltija . Guze Bonnici (b.1907 d.1940) graduated as a doctor from the University of Malta in 1931. His University years were crowned in 1931 by the founding of the Ghaqda tal-Malti (Universita`) by Bonnici and Ruzar Briffa. The Gabra ta' Kitba Maltija series saw the publication of a number of novels written by maltese authors including Il-Qawwa ta' l-Imhabba (1938) and Helsien (1940) by Guze Bonnici himself. The series was also planned to include plays and poetry. While being primarily a reformative novel, Il-Qawwa tal-Imhabba deals also with the medical and social problems of tuberculosis before the availability of adequate therapy. In the preface of the book, Bonnici wrote that "Il-marda tas-sider hu gerha kerha fil-laham haj tal-bniedem u jmiss u jherri ghadd ta' hlejjaq bla qies. Hu aktar hafif biex jintrikebb milli biex jinghaleb u jitfejjaq. U l-aqwa ghorrief, b'hegga u b'sabar qaddisa, ininu u jehdlu taht it-toqol ta' l-istarrig biex jikxfu xi duwa li twaqqaf din il-herba u tnissel xaqq ta' tama f'qalb il-mittiefsa u fi qrabathom. Sa issa l-gherf mexa 'l quddiem hafna, izda ghadu ma wasalx biex iqis ruhu rebbieh fuq dan il-mard. U hi hasra tassew kbira tara quddiemek mijiet ta' zghazagh, fl-ahhjar ta' hajjithom, imejlu rashom ghajjiena u jroddu ruhhom lill-Hallieq, milquta ghal mewt mit-tuberkolozi. Izda f'jum fil-qrib, ghad tinkixef xi duwa li xxejjen il-qawwa qattiela ta' dan il-mard u tnaqqas il-herba li jizra' fil-familji." During the 1930s the incidence of pulmonary tuberculosis averaged 0.64 per 1000 population with a case fatality rate of about 60%. The sick were nursed at the Connaught Hospital at Mdina which was adapted for pulmonary tuberculous cases in 1909. The management at this time was mainly supportive or surgical, besides undertaking preventive measures to control spread of infection. Antibiotic therapy in the form of streptomycin was started in Malta in 1948. Streptomycin was obtained from Streptomyces griseus which was cultured by Waksman in 1944, from a heavily manured field9.

Guze Bonnici also embarked to attempt popular instruction in the medical field. In 1932 he published a book about child care It-Trobbija tat-Tfal. This was divided into three main sections dealing with the pregnant woman and delivery, the second with infant care, and the final section with child care10. It-Trobbija tat-Tfal was followed by a series of articles Taghlim fuq is-Sahha in the vernacular newspaper Il-Berqa published during November 1937 and May 1938. These articles were subsequently in 1939 collected in one publication entitled Il-Gmiel ta' Gisimna which was the first of the series Gabra ta' Taghlim which was to include various aspects of knowledge and trades. Il Gmiel ta' Gisimna is an anatomical and physiological description of the human body utilizing 55 illustrations mostly copied from a standard anatomical book published in Italy [L. Calori: Tavole Anatomiche rappresentanti la struttura del corpo umano. Sassi. Bologna, 1850]11.

A contemporary publisher to Guze Bonnici was Juan Mamo (b.1886 d.1941). Born at Luqa, Mamo was well aware with the social inequalities of the rural population. This awareness promoted his wish to initiate a progessive change in Maltese mentality through cultural propagation. Because of his beliefs, Mamo became a staunch follower of Manwel Dimech and contributed regularly to Il-Bandiera tal-Maltin . He also initiated two newspapers - Il-Ljun [1922] and Il-Fqir Malti [1923] - to promote Dimech's teachings. The central theme of Mamo writings was that the Maltese population should realize its backwardness, and should embark on the road of knowledge. To enable the propagation of knowledge, Mamo established a publishing house Dar Hrug il-Kotba Mehtigin. His first publication in 1930 was the popular socio-political novel Ulied in-Nanna venut fl' Amerca. The novel combines an educational intention with a secure literary ability, and is based on emigration as a social traditional necessity12.

Mamo subsequent publication in 1934 was an informative semi-scientific booklet entitled Giabra ta Sigrieti: ta Xebh-is-sharijiet, ta Misteri, ta Curzita`, ta Arti u Industria, u ricetti - formoli ta l' Acbar Htiega. This book included a number of tricks and remedies for every day problems. The final sections of this book deal with popular medical [remedies no.143-170] and vetinary [no.173-181] medications13.

In 1939 Mamo published an informative book on midwifery practice Obstetricia Illustrata: Tgharrif fuq it-Twelid bil-Qabla w it-Tabib. This compendium of 64 plates contained more than 172 selected figures of modern and ancient engravers with notes in English and Maltese. The book is divided into two main sections showing illustrations from modern and ancient midwifery. Other section include an explaination of medical terms and a translation from the Cow & Gate publication Motherhood. The reproductions were taken from a number of 16th to early twentieth century midwifery books. Seven illustrations are labled as Lithograph Stephani - ex-librix Dr. Nicoloai Gulia. These have been identified as copied from an Italian midwifery book [F. Capuron: Corso teorico-pratico di ostetricia. Della Speranza, Firenze, 1838]. Contemporary to Mamo's obstetric book was a booklet issued by Nestle' & Anglo Swiss Milk Products Ltd in 1939 Twissijiet lill-Ommijiet Zghazagh which dealt with child and infant care14.

Further planned midwifery related publications by J. Mamo included: Illustrated Curious Offspring which was to be a book of plates showing 100 curiosities; and Midwifery seen through Illustrations: Eghlim zmien It-Tqala. Is-Sinjali tat-Tqala containing 30 selected fine plates and clear advice to the pregnant woman (64 pages). Other medically related planned publications included It-Tabib tad-Dar, Kif Tfejjaq Tnax-il Marda, and Ktieb il-Hxejjex li Jfejqu. These publications listed in Obstetricia Illustrata were never issued because of the unexpected demise of Juan Mamo in 1941. Mamo was found dead with broken ribs in the limits of Wied Babu, presumably following a fall of the cliffs while searching for medicinal plants15.

The Second World War brought about a tremendous upheaval in the social circumstances of the population with a general improvement in education. The improvements in socio-economic conditions and improvements in medical care resulted in a significant change in the disease spectrum of the population. Vernacular medical education also received an impetus with the steady publication of popular medical literature in the Maltese language in the form of book, pamphlets or leaflets published by individuals, associations or the Department of Health.

NOTES

1. J. Zammit Mangion: Education in Malta. Studia Editions, Malta, 1992, p.41-47; Census '85. Vol.I - A Demographic Profile of Malta and Gozo. Central Office of Statistics, Malta, 1986, p.77

2. A. Aquilina: History of Maltese Publishing. Cotba tal Moghdija taz Zmien. Heritage. An encyclopedia of Maltese culture and civilization.1993, 68:1353-1356

3. Anonymous: Twissiet fuk il Mard tal Kollea mehrugin mill Gvern biex jixxerdu fost in-nies. Government Printing Office, Malta, 1885, +8p; Anonymous: Fuq il mard tat-tfal u kif nilqulu . Government Printing Office, Government Printing Office, Malta, 1885, +23p.; G. Caruana Scicluna: Chielmtejn fuk il-Pesta u chif yekrida. W. Busuttil, Malta, 1901, +16p.; A. Critien: Id-dubbien u n-nemus u cghif nilkghu ruhna mill-hsarat taghhom . Government Printing Office, Malta, 1929, +16p.; Anonymous: Il-Grieden. Department of Health, Malta, 1936, +4p.; S.L. Pisani: Ktieb il Qabla. P.Debono, Malta, 1883, +105p.; G.B. Schembri: Taghlim ghal l-istudenti ta' l-Iscola tal-Kwiebel ta' l-Isptar Centrali. Government Printing office, Malta, 1897, +114p.; J.S. Galizia: Il Ctieb ta l'Infermier. Government Printing Office, Malta, 1904, +218p.

4. A. Aquilina: op. cit. note 2; A. Preca: Nibzghau ghal Sahhitna. Taghlim ghat-Tfal. Moghdija taz-Zmien No.22, Malta, 1902, p.45-56; E.L. Vella: Taghlim ghall Ommijiet fuk it-Trobbija ta Uliedhom. Moghdija taz-Zmien No.54, Malta, 1906, p.1-30.; F. Borg: Ghajnuna fil mard ghal gharrieda - Fuk l'Epidemji. Moghdija taz-Zmien No. 54, Malta, 1906, p.33-82; F. Borg: Ghajnuna fil mard ghal gharrieda. Guttemberg, Malta, 1880, +40p.

5. F. Borg: Is-Sahha u 'd-Dar. Moghdija taz-Zmien No.61, Malta, 1907, +30p.; F. Borg: Is-Sahha tal ulied. Moghdija taz-Zmien No.110; Malta, 1911, p.1-36; F. Borg: Kelmtejn fuq is-sahha tal ulied. Malta, 1884; L. Manche: Mard l Ghajnejn f'it-Trabi. Moghdija taz-Zmien No. 110, Malta, 1911, p.37-40; G. Busuttil: Fuk il Mard ta' n-nies ta' s-snajja. Moghdija taz-Zmien No.110, Malta, 1911, p.41-80

6. P. Cassar: Medical History of Malta. Wellcome Historical Med Libr, London, 1964, p.358-359; L. Manche: It-Trobbija tat-Tfal jeu Tuissijet ghall ommijiet. Pro Infantia, Malta, 1907, +55p.

7. A. Galea: Alfonso Maria Galea b.1861 d.1941. Heritage. An encyclopedia of Maltese culture and civilization. 1980, 31:[Portrait Gallery]; Reports on the working of Government Departments during the financial year 1911-12. Government Printing Office, Malta, 1912, sec.M:2

8. J. Cautlei: L'ewwel ghajnuna lil mim ikorri. St. John's Ambulance Brigade, Malta, 1916/1934/1938/1943; G.Galea: L-ewwel ghajnuna lil mim ikorri fi zmien ta' Gwerra. Progress Press, Malta, n.d., +22p.

9. A. Galea: Guze Bonnici b.1907 d.1940. Heritage. An encyclopedia of Maltese culture and civilization. 1980, 33:[Portrait Gallery]; G. Bonnici: Il-Qawwa ta' l-Imhabba. Gabra ta' Kitba Maltija, Malta, 1938;Report on the Health conditions of the Maltese Islands and on the work of the Medical and Health Department including the Emergency Medical Services for the year 1940. Government Printing Office, Malta, 1941, p.xii, lxviii-lxx1; Report on the Health conditions of the Maltese Islands and on the work of the Medical and Health Department for the year 1948. Government Printing Office, Malta, 1949, p.xxiv-xxxii, lxix-lxx

10. G. Bonnici: It-Trobbija tat-Tfal. Malta, 1932, +35p.

11. G. Bonnici: Il-Gmiel ta' Gisimna. Progress Press, Malta, 1939, +159p.

12. O. Friggieri: Gwann Mamo. Il-Kittieb tar-Riforma Socjali . Mid-Med Bank Ltd, Malta, 1984; G. Mamo: Ulied in-Nanna venut fl-Amerka. Malta, 1930

13. G. Mamo: Giabra ta Sigrieti: ta Xebh-is-sharijiet, ta Misteri, ta Curzita`, ta Arti u Industria, u ricetti - formoli ta l' Acbar Htiega. The New Art press, Malta, 1934, +80p.; O. Friggieri: ibid

14. G. Mamo: Obstetricia Illustrata. Tgharrif fuq it-Twelid bil-qabla w it-tabib. Malta, 1939, +80p.; G.G.R.: Twissijiet lill-Ommijiet Zghazagh. Nestle', Malta, 1939, +46p.

15. G. Mamo: ibid; O. Friggieri: op. cit. note 11

BOOK CONTENTS

Anonymous: Twissiet fuk il Mard tal Kollea mehrugin mill Gvern biex jixxerdu fost in-nies. Government Printing Office, Malta, 1885, +8p

Anonymous: Fuq il mard tat-tfal u kif nilqulu. Government Printing Office, Government Printing Office, Malta, 1885, +23p.

G. Caruana Scicluna: Chielmtejn fuk il-Pesta u chif yekrida . W. Busuttil, Malta, 1901, +16p.

A. Critien: Id-dubbien u n-nemus u cghif nilkghu ruhna mill-hsarat taghhom. Government Printing Office, Malta, 1929, +16p.

Anonymous: Il-Grieden. Department of Health, Malta, 1936, +4p.

S.L. Pisani: Ktieb il Qabla. P.Debono, Malta, 1883, +105p.

G.B. Schembri: Taghlim ghal l-istudenti ta' l-Iscola tal-Kwiebel ta' l-Isptar Centrali. Government Printing office, Malta, 1897, +114p.

J.S. Galizia: Il Ctieb ta l'Infermier. Government Printing Office, Malta, 1904, +218p.

Cotba tal Moghdija taz-Zmien No. 22 Nibzghou ghal sahhitna. Taghlim ghat-Tfal by A. Preca (1902)

Cotba tal Moghdija taz-Zmien No.54 Taghlim ghall-Ommijiet fuq it-Trobbija ta' Uliedhom by E.B. Vella (1906) This was divided into 11 chapters dealing with various aspects of infant care: I. L 'euuel Curi, II. Il Friex, III. L'Indefa, IV. Il Feskia, V. Ilbies, VI. X'ghandom jeclu it-trabi, VII. Tlakkim, VIII. It-Tlieh tas-Snien, IX. Hrug u Aria, X. Irkad, XI. X'jnhtieg. No. 54 also included Ghajnuna fil mard ghal Gharrieda - Fuk l'Epidemji by F. Borg which included: I. Contusioni; II. Liui, Klih u cosor; III. Feriti; IV. Il Hruk u 's-samta; V. Dhul ta xi Hagia; VI. Il Ghaxua; VII. L'Apuplexia; VIII. Il Convulsioni; IX. Telf tan-nifs; X. Telf tad-demm; XI. Veleni; XII. Rabia tal Clieb; XIII. L'Edpidemja; XIV. It-Tifu; XV. Fl Marsuttin.

Cotba tal Moghdija taz-Zmien No. 61 Is-Sahha u 'd-dar by F. Borg (1907) included: I. Id-Dar; II. Arja-Ventilituri; III. L'arja u 'n-nifs; IV. Tahsir iehor ta l'arja; V. Ventilazioni; VI. Id-Dawl; VII. Ilma, Bjut u Diar; VIII. Cauha u Shana; IX. Umdita'; X. Iz-zina tad-diar.

Cotba tal Moghdija taz-Zmien No. 110 Is-Sahha tal ulied by F. Borg (1911) included: I. Il Hasil; II. Il-Lbies; III. Ir-Rdigh; IV. Il Ftama; V. Il Hrug; VI. Ir-Rkad; VII. Ix-Xaherha; VIII. Is-Snien; IX. Il-Tilkem; X. Loghob u Xoghol; XI. Is-Swat u il Biza'; XII. It Taghlim; XIII. It-Tfal uakt il Mard. It also included a section Mard l Ghajnejn f'it-Trabi written by L. Manche, and Fuk il Mard ta' n-Nies ta' s-Snajja by G. Busuttil. The latter included: I. Is-Zebbiegha; II. Il Bajjada; III. Il Hajjata; IV. Li Scarpan; V. Il Cunjaturi; VI. Il Mastrudaxxi; VII. Il Hassiela u tal-Moghdija; VIII. Il Furnari u l'Ghaggiena; IX. Il Haddedin; X. Ta' t-Tabacc; XI. Is-Sulfarini u il Gigdifogu; XII. In-Nissiegia; XIII. Tal Mtierah; XIV. Is-Sahra.

It-Trobbija Tat-Tfal jeu Tuissijet ghall ommijiet by L. Manche (1907) and translated into maltese by Avv. E.L. Vella contained: I. Chelmtein ghal min jakra; II. Zuieg u reguli li ghandom icunu osservati; III. It-tkala; IV. Il Hlas; V. Uara il Hlas; VI. Irdieh naturali jeu tal omm n tal imreddgha; VII. Irdieh artificiali jeu mil flixcun mil' animal; VIII. Ichel imhallat; IX. Ftama; X. Ilbies tat-tarbija u tat-tfal; XI. Aria, Daul u Ilma; XII. Irkad u Eserciziu; XIII. Educazioni tal Moh u tal Kalb; XIV. Chelmtein fuk il cura fid-dar

It-Trobbija tat-Tfal by G. Bonnici (1932) was divided into three main sections dealing with maternal, infant and child care -- I. Il Cura ta l'Omm; II. It-Tarbija; III. Tfulija - A. L'Euuel Zmien, B. It-Tieni Zmien

Il Gmiel ta' Gisimna by G. Bonnici (1939) is divided into 23 chapters, each with various subsections: 1. Gisem il-Bniedem, 2. Il-Bini wit-Taqsim tal-Gisem, 3. Il-Mohh wis-Sistema Nervuz, 4. Il-Ghajnejn wil-Wiri, 5. Il-Widnejn wis-Smigh, 6. L-Imnieher wix-Xamm, 7. L-Ilsien wit-Toghma, 8. Il-Gilda wil-Mess, 9. Il-Gilda, 10. Id-Demm, 11. Il-Qalb, 12. Il-Katusi tad-Demm, 13. Ic-Cirkolazzjoni tad-Demm, 14. Il-Limfa wil-Katusi Limfatici, 15. Il-Moghdija tan-Nifs, 16. In-Nifs, 17. It-Triq ta' l-Ikel, 18. Is-Sajran ta' l-Ikel, 19. Il-Fwied wil-Frixa, 20. Il-Moghdija ta' l-Awrina, 21. Il-Glandli Endokrini, 22. Il-Metabolismu, 23. Il-Hajja

Obstetricia Illustrata: Tgharrif fuq it-Twelid bil-Qabla w it-Tabib by J. Mamo (1939): Illustrations of Modern Midwifery - Xbiehat tat-tqala w it-twelid tal-lum u l-bierah; Illustrations of Antique Midwifery - Xbiehat tat-tqala w it-twelid tal-qedem; Explanation of Medical Words - Tfissir il-Kliem Tekniku li mieghu tiltaqa' f'dan il-Ktieb Werrej; and Don'ts copied from "Motherhood", published by Cow & Gate for the Benefit of our people - Taghmelxijiet mehudin mill-ktieb Motherhood tal-Cow & Gate ghall-gid sahhet il-poplu.